1517 BROADWAY 2019-07-12 - Laserfiche WebLink

OCIS Intake &to Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# � )\� -- BUILDING PLANNING Intake OK by: -1L_ Date: Intake OK by: Date: 1a- Z,(6-• iq '. Intake Comments: Intake Comments: Assign To: .} lJ ") ❑ Route to Commercial Building ❑Attach to Project No. ❑ oute Building � 0 Route to Historic Reviewer FI -Make this a"W"Permit OK to Route to Other Departments Z'2S—!' 1C* dg/TI/Addn/Rem SizeHold in Planning File Drawer Garage/Accessory Struct. Size Zone ?,v Number of StoriesI Overlay/Agreement rr,,�� Basement ❑No Io1Yes , Fin/ nfin) Nonresidential Use Type of Construction Residential Use 6 Occupancy Group V Proposed No. of Dwelling Units: Occupancy Load Total No. of Dwelling Units: 1 Fire Sprinklers: ❑Update Existing ONew System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes 0 No Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$ Fire Alarm: ❑Update Existing ❑New System ❑Not Req'd School Impact Fee: Total $ Reason Fire Alarm Required: Calculated: Credit: RCW 64.55 MF worksheet req'd for permit? ❑Yes V�,No ❑Everett School Dist ❑Mukilteo School Dist Add'I RCW 64.55 docs required prior to final? ❑Yes rNo Additional Notes: to VALUATION CALCULATION: Total$ I5-I COO kku-c-- 11101, \j��N`� �Q„� �J 14 9 J' Tl3 4 t t— (ivak c 14.x' roved B . Date: 3-4111 PUBLIC WORKS Intake OK by: i114 Date: il 12,$ I 19 Additional Notes: 20 15 6/4.C. 0 WS Intake Comments: PW Worksheet Needed if: i wi�V�ps� i-z—F"-4o-D£- ❑Sys Dev Eval ❑Traffic Mit Eval 0 it f.7�•%-r s-r2a>'_-r -E DSite Work or Drainage Proposed Approved By: CfrifrDate: z/z9//9 �- A`"4te--C__ I: A-0-4 DBackflow Prevention for high hazard: (dental,medical,animals,mortuary,hospital, S -1-4• "46 Err 0 . supportive housing) w10 S`:1 S . DEN. F c..£S. FIRE DEPARTMENT k 'oute this folder for PW Review at end ---PW Review Worksheet Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a separate concurrent PW Review(Green Folder) ❑Route to Fire Drawer---Fire Preliminary Review Notice AND ❑Create Green Folder ❑Submitted Previously ❑Deferred ❑Sending Fire Notes to Project Team 0 This Permit is Approved by Public Works Date: (OK to Route to Other Departments) 0 See PW Review Worksheet and associated attached items Fire Sprinklers: ❑Update Existing ONew System 0 Not Req'd 0 A Separate PW Permit is Required (Permit#: PW ) Fire Alarm: ❑Update Existing ONew System 0 Not Req'd AND ❑ Is located in this folder Chemical Sup: ❑Update Existing❑New System 0 Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) Additional Notes: ❑ Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) Approved By: Date: Public Works has no scope--- PW Not Required Additional Notes: ELECTRICAL .3/8/246// Additional Notes: Approved By: Date: Approved By: Date: